Prevalence of Hepatitis C Virus Antibodies in Primary Glomerulonephritis in Brazil

Lopes, Lucila; Lopes, Edmundo Pessoa de Almeida; Silva, E.; Kirsztajn, Gianna Mastroianni; Pereira, Aparecido B.; Sesso, Ricardo; Ferraz, Maria Lúcia Cardoso Gomes

doi:10.1159/000013393

Cited by 6 publications

(2 citation statements)

References 21 publications

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“…The histologic pattern of "secondary" MPGN is quite similar to type I, and more so in type III MPGN. 22 Thus, detailed clinical history and laboratory evaluation for underlying causes is of great importance. In addition, morphologic changes, such as tubuloreticular structures (e.g., lupus nephritis, hepatitis) and morphology of deposits, such as in cryoglobulinemia, should be carefully evaluated.…”

Section: Discussionmentioning

confidence: 99%

A Study of Membranoproliferative Glomerulonephritis in Iran

1999

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Background:The aim of this study was to review the morphologic patterns of membranoproliferative glomerulonephritis (MPGN) in 100 Iranian patients using light microscopy (LM) and electron microscopy (EM), and to compare the treatment and outcome in 13 patients with two biopsies. Patients and Methods: A retrospective study of 713 kidney biopsies of Iranian patients received between 1981 to 1994 was carried out. Of the 713 kidney biopsies, MPGN (n=106) and membranous glomerulopathy (n=112) made up the highest numbers of cases. Results: Among 100 MPGN patients, 55 (55%) were MPGN type I, 10 were type II (10%), and 35 type III (35%). Eighty-three (83%) had nephrotic proteinuria, 39 (39%) had hematuria, and 52 (52%) were hypertensive. Complement levels were estimated in 58, with low C3 in 10. The glomerular involvement was irregular, with focal hypercellularity in 47 patients (47%), widely patent capillaries in 50 (50%), arteriosclerosis in 48 (48%), and with hyaline change in 25 (25%). Follow-up data (22-130 months) was available in 61 (61%) patients: 6 (10%) died after 14-56 months, 27 (44%) were on maintenance hemodialysis for 15-110 months, and three received transplants. Thirteen patients had detailed follow-up and a second biopsy after 24-120 months. All 13 presented with edema and nephrotic range proteinuria, with hematuria and hypertension in five and azotemia in four. Seven of the 13 patients received initial steroids, followed by antiplatelet or antihypertensive drugs. Four (type III) patients received antiplatelet and antihypertension drugs, and two (type III) received only antihypertensive drugs. In the first biopsy, glomerular changes by light microscopy were non-uniform in 7 of 10 (70%) type III MPGN cases. Vascular changes were absent or mild in 11, and moderate in two. In the second biopsies, 10 showed decrease in cellularity, with many open capillaries, persistence of deposits by EM in all, and progression of vascular sclerosis in eight, and tubulointerstitial changes in 10. Among the 13, six were clinically stable, another six received dialysis followed by transplant in three, and one had relapses with episodes of cryoglobulinemia. Three patients died. Conclusion: There is a high incidence of MPGN in Iranian patients, with a substantial number of type III MPGN cases. Second biopsies showed decreased cellularity, but increase in chronic tubulointerstitial and vascular cases. Steroids did not appear to benefit the outcome in types I and III MPGN patients compared to patients who received antihypertensive and antiplatelet treatment without steroids.

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Section: Discussionmentioning

confidence: 99%

A Study of Membranoproliferative Glomerulonephritis in Iran

1999

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“…Rollino et al 20 , por sua vez, obser varam positividade do anti-HCV em 1 dos 27 pacientes com GN membranosa (GNM). Em São Paulo, pesquisando-se a prevalência do anti-HCV em 81 pacientes com GNs primárias, verificou-se positividade em 2 casos, ambos com GNMP, que correspondem aos casos 1 e 2 do presente estudo 14 . Por outro lado, Yamabe et al 27 , investigando a presença do anti-HCV em 146 pacientes com GNs, observaram positividade em 2 dos 24 casos (8,3%) de GNM e em 6 dos 10 casos (60%) de GNMP.…”

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Glomerulonefrite associada à infecção pelo vírus da hepatiteC

Lopes¹,

Ep²,

Ae³

et al. 1999

Rev. Soc. Bras. Med. Trop.

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We report 4 patients with glomerulonephritis (GN) associated with hepatitis C virus (HCV) infection seen between August 1993 and July 1996. Two of them were male and median age was 41 years. Anti-HCV was detected by enzyme-immunoassay and HCV-RNA by PCR. Serum cryoglobulins, 24-hour proteinuria, and erythrocyte dismorphism were also determined. Viremia, cryoglobulinemia, hematuria and proteinuria were observed in all patients. Liver biopsies revealed inflammatory activity in 3 cases, and renal biopsies revealed membranoproliferative glomerulonephritis in 3 patients and mesangial proliferative glomerulonephritis in 1 patient. Two patients are on specific therapy for HCV infection (IFN in combination with ribavirin) and have presented clinical and laboratory improvement. The occurrence of active liver disease and viremia concurrent with urinary alterations suggests viral involvement in renal disease, a conclusion supported by the by improvement of urinary alterations observed after treatment for HCV. We conclude that the search for viral markers in patients with GN is important since their detection could change the therapeutic approach.

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Extrahepatic manifestations of hepatitis C among United States male veterans

et al. 2002

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Hepatitis C virus (HCV) has been associated with several extrahepatic conditions. To date, most studies assessing these associations involved small numbers of patients and lacked a control group. Using the computerized databases of the Department of Veterans Affairs, we carried out a hospital-based case-control study that examined all cases of HCV-infected patients hospitalized during 1992 to 1999 (n = 34,204) and randomly chosen control subjects without HCV (n = 136,816) matched with cases on the year of admission. The inpatient and outpatient files were searched for several disorders involving the skin (porphyria cutanea tarda [PCT], vitiligo, and lichen planus); renal (membranous glomerulonephritis [GN] and membranoproliferative glomerulonephritis); hematologic (cryoglobulin, Hodgkin's and non-Hodgkin's lymphoma [NHL]); endocrine (diabetes, thyroiditis); and rheumatologic (Sjögren's syndrome). The association between HCV and these disorders was examined in multivariate analyses that controlled for age, gender, ethnicity, and period of military service. Patients in the case group were younger in age (45 vs. 57 years), were more frequently nonwhite (39.6% vs. 26.3%), and were more frequently male (98.1% vs. 97.0%). A significantly greater proportion of HCV-infected patients had PCT, vitiligo, lichen planus, and cryoglobulinemia. There was a greater prevalence of membranoproliferative GN among patients with HCV but not membranous GN. There was no significant difference in the prevalence of thyroiditis, Sjögren's syndrome, or Hodgkin's or NHL. However, NHL became significant after age adjustment. Diabetes was more prevalent in controls than cases, but no statistically significant association was found after adjustment for age. In conclusion, we found a significant association between HCV infection and PCT, lichen planus, vitiligo, cryoglobulinemia, membranoproliferative GN, and NHL. Patients presenting with these disorders should be tested for HCV infection.

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Prevalence of Hepatitis C Virus Antibodies in Primary Glomerulonephritis in Brazil

Cited by 6 publications

References 21 publications

A Study of Membranoproliferative Glomerulonephritis in Iran

A Study of Membranoproliferative Glomerulonephritis in Iran

Glomerulonefrite associada à infecção pelo vírus da hepatiteC

Extrahepatic manifestations of hepatitis C among United States male veterans

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